Improving health care access for low-income people: lessons from ascension health's community collaboratives.

Communities across the nation are struggling with how to improve access to health care for low-income people. We examined seven communities where Ascension Health collaborated with other safety-net providers and organizations to achieve better health care results for patients. Following a five-step model, each community established infrastructure to track the use of services, expand service capacity, coordinate care, and encourage the cost-effective use of providers. These efforts have achieved notable gains, such as in Austin, Texas, where an estimated $5.50 was returned for every dollar spent on asthma care. Challenges remain, including provider competition, inadequate participation by clinicians, difficulties demonstrating impact, and lack of sustainable funding. Lessons gleaned from these community collaborations can be valuable as the nation implements health reform, and safety-net health care systems home in on remaining access issues.